The Research

Our Platform is effective and it receives high usability scores from both healthcare professionals and patients alike.1

We have used our telehealth platform, Health in Motion, in studies related to:

Research graphs
Telehealth Tablet

Why Telehealth and Remote Patient Monitoring (RPM)?

Telehealth & RPM improves quality of life, functional capacity, and access to care!

Over 97% of adults with COPD do not receive pulmonary rehab (PR) due to lack of awareness2, poor availability3, and lack of access.4 5

4 5

Despite its undisputed benefit, fewer than 3% of adults who have been hospitalized for COPD receive PR within 12 months.6

Telehealth can reach people without access to a clinic, and telehealth treatment is effective7 8 9 10 11, and it is cost-saving12 for healthcare providers.

Patients using telehealth can reduce their chances for hospital admission13, increase their life expectancy, and improve their quality of life.14 15 16

The Evidence

A case study around remote pulmonary rehabilitation for COPD

Remote Pulmonary Rehabilitation improves patient outcomes

People who completed home-based pulmonary rehabilitation tended to have fewer COPD-related hospitalizations.17 18

This paper is about "home-based" rehabilitation which is a form of non-clinic PR - they used a weekly phone call to check in with the subject.

Study Participants:

166

(86 at clinics, 80 in the home)

Trial type:

Randomised Controlled Equivalence

View Paper

For Medicare beneficiaries who have been hospitalized for COPD there is a strong association between initiating pulmonary rehabilitation and 1-year survival.19

Patients:

197,376

Trial type:

Meta-analysis

View Paper

Less than 3% of people with COPD receive pulmonary rehabilitation20 21

What prevents people from accessing pulmonary rehabilitation?

Transportation, travel, and location

Illness and comorbidity

Lack of perceived benefit

Disruption to routine

Inconvenient timing

View Paper

Pulmonary rehabilitation results in substantial personal and healthcare cost savings!22 23 24

The widespread adoption of telehealth & RPM PR will save lives, improve quality of life, and save millions in healthcare dollars.

Health in Motion

Our therapeutic remote monitoring telehealth platform

Health in Motion integrates COPD, Fall Prevention, Total Knee Replacement rehab programs, and more.

App Usability

72

System Usability Score

In early 2022 Health in Motion was assessed using the System Usability Scale Survey for the latest study.

The results found that 79.2% of the APP group scored 72 or higher on the SUS questionnaire. Moreover, 45.8% of APP group participants’ SUS scores exceeded 80.3, giving the app a rating of “excellent.”25

Health in Motion Research

COPD

In light of the emerging scientific evidence supporting virtual pulmonary rehab, Blue Marble evaluated the feasibility and efficacy of an 8-week virtual Pulmonary Rehab program using Health in Motion compared with usual care clinic-based pulmonary rehab.26

Control Group:

8 week clinic-based pulmonary rehabilitation

Intervention Group:

8-week virtual pulmonary rehab program using Health in Motion

Participants:

36 participants

Study Type:

Non-Randomized

Study Status:

Completed

Outcome measures

Primary outcome measure:

The primary outcome measures is the change in the 6 Minute Walk Test distance at 8-weeks compared with baseline.

Secondary outcome measures:

14 other outcome measures will also be used to asses patient change, including the Modified Medical Research Council Dyspnea Scale (mMRC), The Medical Outcomes Scale VR-12, and the Timed up and Go Test (TUG)

Fall Prevention

Health in Motion is a powerful tool for screening falls and delivering fall prevention education and exercises to patients in their home.

In 2018 Blue Marble established that Health in Motion is a reliable and valid tool for screening falls remotely.

View the paper

In 2020, Blue Marble found that Health in Motion Fall Prevention Program is feasible, usable, and effective in reducing fall risk.27

Study Status:

Completed

View the abstract

Conclusions

The digital version of the exercise interventions were effective at improving strength and balance, and reducing pain.

In fact, evidence indicated the digital version reduced pain even more than the paper version of the Otago Exercises.

Health in Motion is an effective fall prevention tool, delivering accessible exercise programs and allowing clinicians to closely monitor those at risk.

Total Knee Replacement Prep & Rehabilitation

In 2021, we completed a multi-site feasibility clinical trial of our total knee replacement exercise, education, and assessment tool.28

This study compared the user experience of a downloadable app to guide postoperative home exercises and instruction compared to the same/similar information delivered by paper handouts.

All participants completed home exercises for 30 days following TKR surgery.

Control Group:

In-person Joint Class and 30 day post-operative rehab using traditional paper-based physical therapy home exercise programs.

Intervention Group:

Health in Motion digital Joint Class educational modules and 30 day post-operative rehab using the Health in Motion Total Knee Replacement app.

Participants:

57 participants

Study Type:

Randomized

Outcome measures

Primary outcome measure:

Usability: System Usability Scale

Secondary outcome measures:

TUG, SLST, and 30STS as well as the KOOS JR physical subscale, VR-12 Health Survey physical subscale, Modified Activities-specific Balance Confidence Scale, and PROMIS physical subscale

Results

Primary outcome:

79% of the study participants scored Health in Motion's usability in the "Good" range and 50% scored it as "Excellent".

Secondary outcomes:

No difference in groups was found.

View the paper

Conclusions

The Health in Motion Platform demonstrated good to excellent usability and there were no differences between groups for all of the functional outcomes and patient reported outcomes.29 30

Since Health in Motion is used at home, it may be an effective alternative to providing educational material and exercises for adults prior to and after a total knee arthroplasty.

Health in Motion, along with the easy-to-use clinician portal, may be an effective tool for remote therapeutic monitoring and telehealth for pre-hab and rehab after TKR.

Want to work together?

References

  1. Holland AE, Mahal A, Hill CJ, Lee AL, Burge AT, Cox NS, Moore R, Nicolson C, O'Halloran P, Lahham A, Gillies R, McDonald CF. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. Thorax. 2017 Jan;72(1):57-65. doi: 10.1136/thoraxjnl-2016-208514. Epub 2016 Sep 26. PMID: 27672116; PMCID: PMC5329049.


  2. Barr RG, Celli BR, Martinez FJ, Ries AL, Rennard SI, Reilly JJ, Jr, et al. Physician and patient perceptions in COPD: the COPD resource network needs assessment survey. Am J Med. 2005;118:1415.


  3. Participation in Pulmonary Rehabilitation after Hospitalization for Chronic Obstructive Pulmonary Disease among Medicare Beneficiaries. Spitzer KA, Stefan MS, Priya A, Pack QR, Pekow PS, Lagu T, Pinto-Plata VM, ZuWallack RL, Lindenauer PK Ann Am Thorac Soc. 2019 Jan; 16(1):99-106


  4. https://conference.thoracic.org/program/abstract-search.php?sid=P6817 G. Malla, S. Bodduluri, S. P. Bhatt (2021) A1155 - Availability of Pulmonary Rehabilitation Among Medicare Beneficiaries with COPD. ATS Conference


  5. Bhatt SP. It's Time to Rehabilitate Pulmonary Rehabilitation. Ann Am Thorac Soc. 2019;16(1):55-57. doi:10.1513/AnnalsATS.201809-641ED


  6. Participation in Pulmonary Rehabilitation after Hospitalization for Chronic Obstructive Pulmonary Disease among Medicare Beneficiaries. Spitzer KA, Stefan MS, Priya A, Pack QR, Pekow PS, Lagu T, Pinto-Plata VM, ZuWallack RL, Lindenauer PK Ann Am Thorac Soc. 2019 Jan; 16(1):99-106


  7. Tsai LL, McNamara RJ, Moddel C, Alison JA, McKenzie DK, McKeough ZJ. Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: the randomized controlled TeleR study. Respirology 2017;22:699–707


  8. Bourne S, DeVos R, North M, Chauhan A, Green B, Brown T, et al. Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial. BMJ Open 2017;7:e014580.


  9. Barnes A, Newby C, Chaplin E, Houchen‐Wolloff, Singh SJ. Purposeful physical activity in COPD patients comparing standard and web based pulmonary rehabilitation [abstract]. European Respiratory Journal 2016;48(Supp 60):PA2056. [Google Scholar]


  10. Chaplin E, Hewitt S, Apps L, Bankart J, Pulikottil‐Jacob R, Boyce S, et al. Interactive web‐based pulmonary rehabilitation programme: a randomised controlled feasibility trial. BMJ Open 2017;7(3):e013682. [PMC free article] [PubMed] [Google Scholar]


  11. Chaplin E, Hewitt S, Apps L, Edwards K, Brough C, Glab A, et al. An interactive web‐based programme: a randomised controlled feasibility trial [abstract]. European Respiratory Journal 2016;48(Suppl 60):PA2064. [Google Scholar]


  12. Haesum, L. K. et al. Cost-utility analysis of a telerehabilitation program: a case study of COPD patients. Telemed. J E Health 18, 688-692, (2012).


  13. Liu, S., Zhao, Q., Li, W. et al. The Cost-Effectiveness of Pulmonary Rehabilitation for COPD in Different Settings: A Systematic Review. Appl Health Econ Health Policy 19, 313–324 (2021). https://doi.org/10.1007/s40258-020-00613-5


  14. Bhatt, S.P.; Patel, S.B.; Anderson, E.M.; Baugh, D.; Givens, T.; Schumann, C.; Sanders, J.G.; Windham, S.T.; Cutter, G.R.; Dransfield, M.T. Video Telehealth Pulmonary Rehabilitation Intervention in Chronic Obstructive Pulmonary Disease Reduces 30-Day Readmissions. Am. J. Respir. Crit. Care Med. 2019, 200, 511–513.


  15. Lewis, A.; Knight, E.; Bland, M.; Middleton, J.; Mitchell, E.; McCrum, K.; Conway, J.; Bevan-Smith, E. Feasibility of an online platform delivery of pulmonary rehabilitation for individuals with chronic respiratory disease. BMJ Open Respir. Res. 2021, 8, e000880.


  16. Rassouli, F.; Boutellier, D.; Duss, J.; Huber, S.; Brutsche, M.H. Digitalizing multidisciplinary pulmonary rehabilitation in COPD with a smartphone application: An international observational pilot study. Int. J. Chron. Obstruct. Pulmon. Dis. 2018, 13, 3831–3836.


  17. Albores, J.; Marolda, C.; Haggerty, M.; Gerstenhaber, B.; Zuwallack, R. The use of a home exercise program based on a computer system in patients with chronic obstructive pulmonary disease. J. Cardiopulm. Rehabilt. Prev. 2013, 33, 47–52.


  18. Holland AE, Mahal A, Hill CJ, Lee AL, Burge AT, Cox NS, Moore R, Nicolson C, O'Halloran P, Lahham A, Gillies R, McDonald CF. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. Thorax. 2017 Jan;72(1):57-65. doi: 10.1136/thoraxjnl-2016-208514. Epub 2016 Sep 26. PMID: 27672116; PMCID: PMC5329049.


  19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329049/#SM1


  20. Lindenauer PK, Stefan MS, Pekow PS, Mazor KM, Priya A, Spitzer KA, Lagu TC, Pack QR, Pinto-Plata VM, ZuWallack R. Association Between Initiation of Pulmonary Rehabilitation After Hospitalization for COPD and 1-Year Survival Among Medicare Beneficiaries. JAMA. 2020 May 12;323(18):1813-1823. doi: 10.1001/jama.2020.4437. PMID: 32396181; PMCID: PMC7218499.


  21. Keating A, Lee A, Holland AE. What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review. Chronic Respiratory Disease. May 2011:89-99. doi:10.1177/1479972310393756


  22. Spitzer KA, Stefan MS, Priya A, Pack QR, Pekow PS, Lagu T, Pinto-Plata VM, ZuWallack RL, Lindenauer PK Participation in Pulmonary Rehabilitation after Hospitalization for Chronic Obstructive Pulmonary Disease among Medicare Beneficiaries. Ann Am Thorac Soc. 2019 Jan; 16(1):99-106


  23. Christopher Mosher, Michael Nanna, Oliver Jawitz, Vignesh Raman, Norma Farrow, Samia Aleem, Neil MacIntyre, Scott Palmer, Evan Myers, COST-EFFECTIVENESS OF PULMONARY REHABILITATION IN US ADULTS WITH COPD, Chest, Volume 158, Issue 4, Supplement, 2020, Pages A2059-A2060, ISSN 0012-3692, https://doi.org/10.1016/j.chest.2020.08.1781. (https://www.sciencedirect.com/science/article/pii/S0012369220339672)


  24. Haesum, L. K. et al. Cost-utility analysis of a telerehabilitation program: a case study of COPD patients. Telemed J E Health 18, 688-692, (2012).


  25. https://link.springer.com/article/10.1007%2Fs40258-020-00613-5


  26. Assessment of a Downloadable Application with Avatar Guidance for PT-prescribed Home Exercise after Total Knee Arthroplasty: a 30-day Feasibility Study. Joel Carmichael, DC, PhD, Sheryl Flynn, PT, PhD, Tamara Struessel, PT, DPT, Stefano Bini, MD, Michael Bade, PT, PhD, Jennifer Stevens-Lapsley, PT, PhD (paper in preparation).


  27. missing_key


  28. https://www.clinicaltrials.gov/ct2/show/NCT03801330?term=Flynn%2C+Sheryl&draw=2&rank=2


  29. Flynn SM, Oviedo VY, Kurchian CR, Pu W. Feasibility, Usability, and Efficacy of Health in Motion Otago-a Digital Fall Prevention Program Journal of Geriatric Physical Therapy. 43(1):1-2, January/March 2020.


  30. S.M. Flynn, V.Y. Oviedo, W.N. Hoffmann J. Stevens-Lapsley, P. Roberts, S. Bini (2018). Reliability, Validity, and Usability of a digital education and self-assessment app for adults with knee osteoarthritis. Gerontechnology, 17(suppl),158s https://doi.org/10.4017/gt.2018.17.s.154.00


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